Computerized education system for teaching patient care

ABSTRACT

An interactive, computerized education system for teaching patient care includes an interactive computer program for use with a simulator, such as a manikin, and virtual instruments for performing simulated patient care activity under the direction of the program. The program displays a selection of modules to assist a user in learning patient care protocols, the modules being selectable by the user for providing different interactive training sessions involving the protocols. The virtual instruments are used with the simulator in performing the patient care activity, the virtual instruments cooperating with sensors that interface with the computer program for providing feedback to the program regarding the activity and confirming proper placement and use of the virtual instruments on the simulator.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. Ser. No. 08/643,435, filedMay 8, 1996, U.S. Pat. No. 5,853,292.

BACKGROUND OF THE INVENTION

The present invention relates generally to an interactive, computerizededucation system for teaching patient care, and more particularly tosuch a system for use in conducting life support training sessions usingvirtual instruments in cooperation with a manikin.

Multiple and interrelated life support skills, such as those taught inBasic Life Support (BLS) courses and Advanced Cardiac Life Support(ACLS) courses, have conventionally been taught using a number ofdifferent training devices such as, for example, a training manikinconfigured to simulate a human patient. Hypothetical emergencysituations are simulated with the manikin and students utilizeinstruments to monitor the manikin for its vital signs, such as itssystolic and diastolic pulse, and its EKG. The students then takeresponsive action and observe the effects of their actions on themanikin.

A drawback to the foregoing practice is that large capital outlays mustbe made for the required equipment. The required manikin is relativelyexpensive, particularly if it is sufficiently sophisticated to be usedto teach a broad variety of skills. For example, one such manikin,provided by Loral Data Systems, is excessive in its cost in part becausethe instruments used to monitor the manikin are the same as those whichare used in actual practice. While such instruments may be borrowed froma practicing physician, their availability in a complete kit with thetraining equipment is preferred. Consequently, the use of these manikinsand associated instruments is prohibitively costly for many studentsand, as a result, many students must forego needed training or settlefor less comprehensive training than they may otherwise receive.

Other, more recently developed training manikin systems are alsodeficient. For example, Nasco has developed a “crisis” manikin whichincludes an arm that simulates blood pressure, and generates Korticoffsounds that may be detected by a stethoscope. Pads are also provided forapplying defibrillators to the Nasco manikin. Real defibrillators,however, are required with the Nasco manikin which, in addition to beingexpensive, also pose a danger from the high quantity of energy thatpasses through them. Laerdal Medical Corporation has developed“hardware-oriented” manikins that are specifically designed for certaininstruments and are, therefore, relatively expensive and of limitedversatility and expandability. Armstrong has developed a manikin that isuseful for training with arrhythmias, but is very limited otherwise. Forexample, the Armstrong manikin has no provision for using manyinstruments, such as a pacer, that is commonly needed in a “Code”situation. The foregoing training manikin systems do not integrate abroad variety of instruments commonly used in “Code” situations, andfurthermore, are adaptable to a wide variety of different kinds of“hands-on” training scenarios in a cost efficient manner.

Multiple and interrelated life support skills may, alternatively, betaught from less expensive resources such as textbooks and flash cards.For example, Grauer and Cavallaro have authored a textbook entitled“ACLS Volumes I and II: Certification Preparation and A ComprehensiveReview” and have developed flash cards entitled the “1994 ACLS PocketReference” both of which attempt to teach such skills. The AmericanHeart Association has published an authoritative reference on AdvancedCardiac Life Support (ACLS). While providing a low cost source forlearning theory, textbooks and flash cards clearly lack the importantbenefit that can only be acquired from “hands-on” training and practice.Training materials of the foregoing type must also be updated frequentlywith advances in medical training, making it difficult for users to becurrent in recommended teachings.

Therefore, what is needed is a system for enabling students to learn,through “hands-on” training, comprehensive multiple and interrelatedlife support skills, without sacrificing the experience gained bystudents in using instruments in a simulated patient treatmentsituation, and which system is readily expandable and updatable withoutlarge capital outlays.

SUMMARY OF THE INVENTION

The present invention, accordingly, provides an interactive computerizededucation system for teaching patient care utilizing a computer programin cooperation with virtual instruments to perform patient careactivities on a simulator such as a manikin.

To this end, an interactive, computerized education system for teachingpatient care includes a computer program for use with a simulator, suchas a manikin, and virtual instruments for performing simulated patientcare activity under the direction of the program. The program displays aselection of modules to assist a user in learning patient careprotocols, the modules being selectable by the user for providingdifferent interactive training sessions involving the protocols. Thevirtual instruments are used with the simulator in performing thepatient care activity and cooperate with sensors that interface with thecomputer program for providing feedback to the program regarding theactivity and confirming proper placement and use of the virtualinstruments on the simulator.

An advantage achieved with the present invention is that students may beprovided with virtual instruments that are much less expensive than realinstruments, but that look, feel, and act like real instruments.

Another advantage of the present invention is that training may beperformed on a readily-available, sensor-equipped manikin, therebyobviating the need for an actual victim.

Another advantage of the present invention is that a student may pacehimself as he progresses through the training.

Another advantage of the present invention is that it is easilytranslatable and adaptable to different kinds of training scenarios.

Another advantage of the present invention is that the computer program,virtual instruments, and sensors, and hence the entire system, may beeasily updated or replaced to ensure that state-of-the-art training isprovided and is in accord with approved medical procedures andstandards.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a block diagram of a computerized education system of thepresent invention.

FIG. 2 is a schematic diagram of the system of FIG. 1 illustrating itsuse in conjunction with a manikin.

FIG. 3 is a schematic diagram of the computer interface module of thesystem of FIG. 2.

FIGS. 4a-4 e illustrate various views of an EKG monitor for use with thesystem of FIG. 2.

FIGS. 5a-5 d illustrate various views of a blood pressure cuff and afinger cuff for use with the system of FIG. 2.

FIGS. 5e-5 h illustrate various views of defibrillators for use with thesystem of FIG. 2.

FIGS. 5i-5 j illustrate cross-sectional views of sensors for use withthe defibrillators of FIGS. 5e-5 h.

FIG. 6 is a screen display generated by the program of the system ofFIG. 1.

FIG. 7 is a screen display generated upon selection of the BLS module ofthe display of FIG. 6.

FIG. 8 is a screen display of a decision tree of available menu items ofthe BLS module of FIG. 7.

FIG. 9 is a screen display of introduction generated upon selection ofan introduction menu item of the decision tree of FIG. 8.

FIGS. 10-12 are screen displays of CPR graphics generated during a CPRtraining sequence initiated by selection of a CPR menu item of thedecision tree of FIG. 8.

FIG. 13 is a screen display generated upon selection of the Airwaysmodule of the display of FIG. 6.

FIG. 14 is a screen display of a decision tree of available menu itemsof the Airways module of FIG. 13.

FIGS. 15-16 are representative graphical screen displays generated bythe Airways module of FIG. 13.

FIG. 17 is a screen display generated upon selection of the Intravenousmodule of the display of FIG. 6.

FIG. 18 is a screen display of a decision tree of available menu itemsof the Intravenous module of FIG. 17.

FIG. 19 is a representative graphical screen display generated by theIntravenous module of FIG. 17.

FIG. 20 is a screen display generated upon selection of the Electricalmodule of the display of FIG. 6.

FIG. 21 is screen display of a decision tree of available menu items ofthe Electrical module of FIG. 20.

FIGS. 22-24 are representative graphical screen displays generated bythe Electrical module of FIG. 20.

FIG. 25 is a screen display generated upon selection of the Arrhythmiasmodule of the display of FIG. 6.

FIG. 26 is a screen display of a decision tree of available menu itemsof the Arrhythmias module of FIG. 25.

FIG. 27 is a screen display of a decision tree of available menu itemsof the Drugs module of FIG. 6.

FIG. 28 is a representative screen display generated by the Drugs moduleof FIG. 27.

FIG. 29 is screen display generated upon selection of the Treatmentsmodule of the display of FIG. 6.

FIG. 30 is a screen display of a decision tree of available menu itemsof the Treatments module of FIG. 29.

FIG. 31 is a screen display of a decision tree of available menu itemsof the BLS Test module of FIG. 6.

FIG. 32 is a representative screen display generated by the BLS Testmodule of FIG. 31.

FIG. 33 is a screen display generated upon selection of the ACLS moduleof the display of FIG. 6.

FIG. 34 is a screen display of a decision tree of available menu itemsof the ACLS module of FIG. 33.

FIG. 35 is a representative screen display generated by the module ofFIG. 33.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

In FIG. 1, the reference numeral 10 refers, in general, to acomputerized education system of the present invention. The system 10includes a computer 12 (with display), a training program 14 foroperation thereon, and a computer interface module (CIM) 16 connected tothe computer 12. One or more virtual instruments 18 and one or moresensors 20 are also connected to the CIM 16. As will be explained indetail below, the sensors 20 are positioned on a simulator device, suchas a patient care manikin (FIG. 2), and on the virtual instruments 18,which are used in training sessions on the manikin, in cooperation withtraining modules of the program 14 that operate on the computer 12 ininteractive training sessions. While a manikin is shown in the preferredembodiment of the system 10, it is understood that the simulator devicemay be any type of anatomical or gynecological device or other deviceupon which simulated training of some sort, medical or otherwise, isdesired.

Referring also to FIG. 2, the computer 12 is preferably a notebookcomputer, although any other computer may be utilized. The computer 12includes a central processing unit (CPU, not shown), such as an Intel80486 microprocessor or a faster microprocessor, and associated memoryand circuitry (not shown). The associated memory preferably comprises atleast 4 megabytes of random access memory (RAM) and a hard disk memoryfor storing and executing the training program 14, described below. Akeyboard 12 a, a mouse 12 b, and a display 12 c provide a user interfaceto the computer 12. A serial port (not shown) provides an interface tothe CIM 16. Although optional, a color video monitor 22 and a printer 24also are operatively connected to the computer 12 through appropriateports (not shown).

Referring to both FIGS. 2 and 3, the CIM 16 is operatively connected viaa line 26 to the serial port (not shown) of the computer 12 forproviding an interface between the computer 12 and the sensors 20 (FIG.1), which sensors, in the present embodiment, are positioned on thevirtual instruments 18 and on a patient care simulator in the form of amanikin 28 configured to resemble a life-size human.

The CIM 16 receives operating power via a power line 30 (FIG. 2) from aconventional power source, such as a wall AC outlet (not shown),filtered through a transformer (not shown), or is otherwise providedusing batteries (not shown). A speaker 32 (FIG. 2) is included with theCIM 16, for providing audio feedback and instruction as furtherdescribed below, and a rheostat control 34 is provided for adjusting thevolume of the speaker 32.

The CIM 16 includes a number of ports 36 (CIM ports 36) to which thevirtual instruments 18 and sensors 20 are connected. The CIM 16 alsoincludes a processor circuit 38 (FIG. 3) connected for receiving inputsignals from the virtual instruments 18 and the sensors 20 through theCIM ports 36. As will be described in detail below, the processorcircuit 38 (such as a RISC-based processor made by Microchip, Inc. ofChandler, Ariz., as model number PIC 16C74-10) processes the receivedinput signals to provide feedback information to the computer 12pertaining to activity performed by a user on the manikin 28, whichinformation is used by the program 14 for providing interactive trainingsessions. The CIM 16 additionally includes an audio chip 39 responsiveto the processor circuit 38 for supplying electrical current via therheostat control 34 to cause the speaker 32 to produce heart and lungsounds and other body sounds.

The CIM ports 36 include an intravenous/endotracheal (IV/ET) port 40, aventilation port 42, a compression port 44, an electrocardiogram (EKG)port 46, a blood pressure, pulse oximeter, hears ate(BP/O_(SAT)/HEARTRATE) port 48, a temporary external pacer port 50,automatic external defibrillator (AED) port 52, and sternum and apexmanual defibrillator ports 54, 56. FIG. 3 illustrates in detail thesignal lines comprising the CIM ports 36 and shows their connection tothe processor circuit 38. Notably, the ventilation port 42 and thecompression port 44 include respective self-nulling circuits 43 and 45,each of which includes a negative 12 volt bias.

The connection of the virtual instruments 18 and the sensors 20 to theCIM ports 36 will now be described in connection with FIGS. 2-5. Thevirtual instruments 18 include a metallic IV needle 18 a, an ET tube 18b, an EKG monitor 18 c, a BP cuff 18 d, a pulse oximeter finger cuff 18e, a temporary external pacer 18 f, and AED 18 g, and sternum and apexmanual defibrillators 18 h, 18 i. The sensors 20 that correspond withthe virtual instruments 18, with respect to their nature and preciseplacement in the manikin 28, depend upon the virtual instrument activitybeing monitored and in this context are described in detail below.

The metallic IV needle 18 a is used in the confirmation of venouscannulation in the antecubital region of an arm of the manikin 28. Asensor 20 a is embedded within an antecubital region of an arm of themanikin 28. The sensor 20 a comprises an insulator sandwiched betweentwo layers of conductive material (not shown), which layers ofconductive material may, for example, be fabricated from nylon clothimpregnated with silver. The nylon cloth has an appropriate thicknessand weave density for permitting the metallic needle 18 a to passthrough the cloth at a low acute angle (e.g., 20°) into a vein in thearm of the manikin 28. The conductive layers of the sensor 20 areelectrically coupled by a line 58 to the IV/ET port 40. It can beappreciated that when the metallic needle 18 a is correctly passedthrough the two conductive layers, i.e., when the needle correctlycannulates the vein in the arm of the manikin 28, a circuit is completedbetween the layers, and the circuit completion is sensed by the CIM 16via the line 58 and the port 40, thereby confirming correct cannulationof the vein.

The ET tube 18 b is used to confirm proper placement in the trachealairway of the manikin 28. A sensor 20 b, comprising an optical sensor ofconventional design, is mounted in the wall of the trachea of themanikin 28 and connected by a line 60 to the IV/ET port 40. The ET tube18 b is fitted with a piece of reflective tape 18 b′ fitted near thedistal, or lower, end of the tube. Correct placement of the ET tube 18 bin the trachea is confirmed when the distal reflective tip of the ETtube interrupts the beam of the optical sensor 20 b.

An air line 62 is similarly mounted in tracheal wall of the manikin 28and is connected to the ventilation port 42. A sensor circuit,designated generally as part of the port 42 and illustrated in FIG. 3,is located within the CIM 16 and is connected to the air line 62 so thatwhen cardiopulmonary resuscitation (CPR) ventilation is performed on themanikin 28, the CIM 16 monitors, via the air line 62 and the sensor ofthe port 42, the timing and magnitude of the pressure and volume of theventilation procedure.

A compression bladder 64 is embedded within the chest cavity of themanikin 28 for sensing and confirming proper execution of a CPR chestcompression procedure, for example. The bladder 64 is connected by anair line 66 to the compression port 44 in the CIM 16. A compressionsensor circuit, designated generally as part of the compression port 44(FIG. 3), is positioned within the CIM 16 and is connected to the airline 66 via the port 44. The compression sensor circuit of the port 44includes circuitry (as illustrated) for confirming the timing andmagnitude of compression.

FIGS. 4a-4 e illustrate an EKG monitor 18 c. The EKG monitor 18 cincludes a cable 68 that connects to the EKG port 46 and trifurcatesinto a white negative sensing patch 70, a red positive sensing patch 72,and a black ground sensing patch 74 for connection to the appropriateregions, respectively, of the torso of the manikin 28. Electrical leads71, 73, and 75 connected to the respective color-coded patches 72, 74,and 76 are depicted at one end of the cable 68 in FIG. 4b for connectionto the EKG port 46 (FIG. 3). The sensing patches 70-74 comprise twospaced sections of conductive velcro 76 a, 76 b mounted to an insulateddisc 78 with separate electric lines 80 a, 80 b of the cable 68connecting to each of the velcro sections 76 a, 76 b. Eyelet rivets 82a, 82 b secure the velcro sections 76 a, 76 b conductively to the lines80 a, 80 b, respectively. Adhesive filler 84 fills the space betweenfront and back portions of the disc 78. Sensors 20 e, 20 f and 20 g(FIG. 2) are mounted on the correct regions of the torso of the manikin28, respectively. The sensors 20 e, 20 f, 20 g each comprise a singlepad of conductive velcro configured so that when the sensing patches 70,72, 74 engage the respective sensors, an electrical circuit is completedbetween the velcro sections 76 a, 76 b and the lines 80 a, 80 b of eachof the three sensing patches 70, 72, and 74. In this manner, the CIM 16,through the EKG port 46, is able to confirm proper placement of the EKGmonitor 18 c on the manikin 28. As will be subsequently described, thistechnique is also used with the AED 18 g and the pacer 18 f virtualinstruments 18.

FIGS. 5a-5 d illustrate details of the BP cuff 18 d and the pulseoximeter finger cuff 18 e. The cuffs 18 d, 18 e are configured togetherwherein a cable 86 is provided that connects to the BP/OSAT/HEARTRATEport 48 and bifurcates into the respective cuffs. Electrical leads 86 aand 86 b connected to the respective cuffs 18 d and 18 e are depicted atone end of the cable 86 in FIG. 5b for connection to the EKG port 48(FIG. 3). As shown in FIGS. 5c-5 d with respect to the finger cuff 18 e,a tactile switch 88 connected to a line 90 of the cable 86 is mounted inthe finger cuff and is activated to complete a circuit when the cuff issecured properly with velcro (male) 91 a and velcro (female) 91 b to thefinger of the manikin 28. Similar switch circuitry, though not shown, iscontained in the BP cuff 18 d.

Referring again to FIG. 2, another of the virtual instruments 18 is atemporary external pacer 18 f. The pacer 18 f connects to the pacer port50 and includes a cable 92 that bifurcates into two sensing patches 94and 96. The sensing patches 94, 96 are similar to those described withreference to the EKG monitor sensing patches 70, 72, 74 (FIGS. 4a-4 d).Sensor pads 20 h, 20 i are located on the torso of the manikin 28 in theappropriate locations for receiving the sensing patches 94, 96 and areused in the same manner described previously with respect to the EKGmonitor sensing patches 70, 72, 74 to confirm the proper placement ofthe pacer 18 f on the manikin 28 to the CIM 16.

The automatic external defibrillator (AED) 18 g connects to the AED port52 and includes a cable 98 that bifurcates into two sensing patches 100,102. The sensing patches 100, 102 are similar to those described withreference to the EKG monitor sensing patches 70, 72, 74 (FIGS. 4a-4 d).Sensor pads 20 j, 20 k are located on the torso of the manikin 28 in theappropriate locations for receiving the sensing patches 100, 102 and areused in the same manner described previously with respect to the EKGmonitor sensing patches 70, 72, 74 to provide a confirmation to the CIM16 that the AED 18, is properly placed on the manikin 28.

Referring to FIG. 2 and FIGS. 5e-5 j, the sternum and apex manualdefibrillators 18 h, 18 i are connected by lines 104, 106, respectively,to the sternum and apex ports 54, 46, respectively, of the manikin 28.The defibrillators 18 h, 18 i simulate real defibrillators but do notproduce a charge. The defibrillators 18 h, 18 i include plates 108, 110,respectively, on the bottom surfaces thereof. The plates 108, 110 definerespective unequally sized openings 108 a, 110 a, the opening 110 abeing larger than the opening 108 a. Switches 109, 111 are recessedwithin the openings 108 a, 110 a, respectively, so that they areactivated upon engagement with switch activators 20 j′, 20 k′ protrudingfrom the sensor pads 20 j, 20 k. The switch activators 20 j′, 20 k′ aresized so that they may fit within the openings 108 a, 110 a,respectively. The activator 20 k′ is larger than the activator 20 j′,and accordingly won't fit within the smaller opening 108 a, therebyenabling the computer 12 to ascertain whether the defibrillators 18 h,18 i are correctly placed on the manikin 28. The defibrillators 18 h, 18i include a charge button 112 and a discharge/activation button 114, forsimulating the use of actual defibrillator equipment. The CIM 16confirms correct placement and use of the defibrillators 18 h, 18 i byinsertion of the activators 20 j′, 20 k′ in the openings 108 a, 110 a,resulting in the closure of the switches 109, 111.

FIGS. 6-35 illustrate details the graphical user interface for thesystem 10. In particular, FIGS. 6-35 illustrate operation of thetraining program 14 on the computer 12 in cooperation with thesensor-equipped manikin 28, the sensor-equipped virtual instruments 18,and the CIM 16. It should be noted that algorithms incorporated into theprogram 14 follow BLS and ACLS guidelines set forth by the AmericanHeart Association.

The training program 14 is written in any suitable programming languagefor operation on a standard PC or other computer 12. While not shown, itis understood that the program 14 is stored on a computer-readablemedium, such as a floppy diskette, a CD, or a hard drive, and isexecuted on the computer 12. The representative screen displays (shownbelow) of the program 14 are understood to be presented on the display12 c or the monitor 22.

FIG. 6 illustrates an introductory screen display 600 of the program 14.The display 600 includes a teaching station selection box 602 and atesting station selection box 604. The teaching station selection box602 includes a plurality of teaching stations, i.e., modules, 606-618,represented by graphical buttons, any one of which may be selected bythe mouse 12 b for directing program execution to the teaching moduleidentified on the selected button. Similarly, the testing stationselection box 604 includes two testing modules 620, 622 represented bygraphical buttons, either of which may be selected by the mouse 12 b fordirecting program execution to the test module identified on theselected button. An exit command button 624, also placed in the testingstation selection box 604, may be selected for exiting from the program14. It is understood that the selection of a button or menu item in thepresent program may be effected by using the “point-and-click” featureof the mouse 12 b, by using an Alt-key combination, or by using anyother desired technique that is available. The display 600 also includesa title box 626 as well as three ornamental display boxes 628-632 whichare representative of graphical displays provided in subsequent modulesof the program, described below.

Referring to FIGS. 6 and 7, if the BLS module 606 is selected, thenprogram execution proceeds to display an instruction screen 700, shownin FIG. 7. The display screen 700 includes a text box 702 whichdescribes the BLS module 606, and a menu bar 704 which includes a numberof menu items 706-714, any one of which may be selected for directingfurther execution of the program 14.

FIG. 8 illustrates a decision tree structure 800 followed by the BLSmodule 606. The available menu items include an Intro (i.e., anIntroduction) item 706, a CPR item 708, an FBO (i.e., a Foreign BodyObstructions) item 710, a Practice item 712, and a Quit command item714. Selection of the Intro item 706 displays a BLS introduction screen900 and a text box 902 as shown in FIG. 9.

Referring to FIGS. 7-12, upon selection of the CPR item 708, the user isprompted with items 802 and 804 for requesting a CPR action sequencewith one or two rescuers, respectively. Upon the selection of item 802or 804, the program 14 displays a CPR introductory screen 1000 and textbox 1002 as shown in FIG. 10. Three command buttons 1004, 1006, 1008 areprovided at the bottom of the screen 1000 for allowing a user to proceedback to a previous screen, to proceed forward to a next screen, or toexit from the BLS module 606, respectively. Subsequent screens displaysequential actions which integrate the basic concepts of CPR, andinclude graphical images such as the image 1100 shown in FIG. 11.

Selection of the FBO item 710 (FIG. 8) directs the program 14 to displaytechniques for dealing with foreign body obstructions (FBO).

Selection of the Practice item 712 directs execution of the program 14to provide a selection of Practice menu items 806-814, as shown. Uponselection of the CPR Practice item 806, the user may select among aplurality of action sequences 816-822, to receive training in CPR withone rescuer, CPR with two rescuers, or CPR ventilation/compressiontechniques with one rescuer, or with two rescuers, respectively. The CPRtest speed practice menu item 808 prompts the user to select item 824 or826 to adjust the speed for an action sequence having either one or tworescuers, respectively. The Setup menu item 810 enables the user tospecify that the action sequences 828-836 comprise 2, 4, 6, 8, or 10compression/ventilation cycles, respectively.

The Results/Print practice menu item 812 directs the program 14 torecord the time and magnitude of the compression and ventilationactivity executed by the user on the manikin 28. It can be appreciatedthat compression and ventilation data is acquired from pressure wavessensed by the CIM 16 through the tubes 62 and 66 when the chest of themanikin 28 is compressed and when air is ventilated in the trachea ofthe manikin. The recorded results may be displayed, as illustrated bydisplay screen 1200 in FIG. 12, on the display 12 c or the displayscreen 22 or, alternatively, may be printed on the printer 24 to therebyprovide a hard copy of the results. As shown in FIG. 12, the results maybe readily evaluated to determine whether the compression and/orventilation actions are high, or low, or are OK. Selection of the Quititem 814 directs the program 14 to exit from the Practice item 712, andselection of the Quit item 714 directs the program to exit from the BLSmodule 608.

Referring to FIG. 6 and FIGS. 13-16, selection of the Airways module 608directs execution of the program 14 to a provide information regardingairway techniques. FIG. 13 illustrates a display screen 1300 and textbox 1302 with information on opening an airway, for example. A menu bar1304 includes menu items 1306-1312 directed to Anatomy, Opening theAirway, Action Sequence, and Quit, as shown. FIG. 14 illustrates a menutree structure of the Airways module 608. The Anatomy item 1306 includesteaching sessions 1402-1408 directed to Upper Torso, Mouth, Head andNeck, and Vocal Cords, respectively. Representative graphics screens1500 and 1600 pertaining the teaching sessions 1402-1408 are shown inFIGS. 15 and 16, respectively.

The Opening the Airway item 1308 includes teachings sessions 1410-1420on Introduction, Hyperventilation, Patient Position, Vocal Cords,Endotracheal Tube, and Confirming Placement, respectively. The actionsequence item 1310 includes teaching sessions 1422, 1424 on PatientBreathing, and Patient NOT Breathing, respectively. The Quit item 1312is selected to exit the airways module 608.

Referring to FIG. 6 and FIGS. 17-19, selection of the Intravenous module610 directs execution of the program 14 to a provide informationregarding intravenous insertion techniques. FIG. 17 illustrates a screendisplay 1700 with a text box 1702 having information on selecting menuitems of the Intravenous module 610. A menu bar 1704 includes menu items1706-1712 directed to Peripheral, Endotracheal, Central and Quit,respectively. FIG. 18 illustrates a menu tree structure of theIntravenous module 610. The Peripheral item 1706 includes teachingsessions 1800-1806 directed to Antecubital Vein, External Jugular Vein,Saphenous Vein, and Intraosseous Access, respectively. The Endotrachealmenu item 1708 includes a teaching session 1810 on the administration ofALE drugs in thr ET tube 18 b. The Central menu item 1710 includesteaching sessions 1812-1816 on Femoral Vein, Subclavian Vein, andInternal Jugular Vein, respectively. A representative graphic screendisplay 1900 pertaining the teaching sessions of the Intravenous module610 is shown in FIG. 19. The Quit item 1712 is selected to direct theprogram to exit the Intravenous module 610.

Referring to FIG. 6 and FIGS. 20-24, selection of the Electrical module612 directs execution of the program 14 to a screen display 2000, shownin FIG. 20, and text box 2002 having information on selecting menu itemsof the Electrical module 612. The screen 2000 further includes virtualinstrument boxes 2004-2010 pertaining to virtual instruments thatinclude an EKG monitor 18 c, a defibrillator 18 h, 18 i, a vitalsmonitor, and a pacer 18 f, respectively. It is understood that thesevirtual instruments may be controlled/operated by the mouse 12 b forsimulating patient care activity in connection with the module 612.

A menu bar 2012 includes menu items 2014-2024 directed to EKG,Defib/Cardio, Vital Signs, Ext. Pacing, Implants, Trace, and Quit,respectively. FIG. 21 illustrates a menu tree structure of theElectrical module 612. The menu items 2014-2022 include teachingsessions 2100-2128 as shown. Representative graphic screens 2200-2400pertaining the teaching sessions of the Electrical module 612 are shownin FIGS. 22-24. Quit item 2024 is selected to direct the program 14 toexit from the Electrical module 612.

Referring to FIG. 6 and FIGS. 25-26, selection of the Arrhythmias module614 directs execution of the program 14 to a provide informationregarding arrhythmia morphologies. FIG. 25 illustrates a screen 2500with a text box 2502 having information pertaining to the selection ofmenu items available with the Arrhythmias module 614. The screen 2500further includes an EKG trace box 2504 pertaining to example traces ofarrhythmias described in teaching sessions.

A menu bar 2506 includes menu items 2508-2514 directed to Arrhythmias,Treatment, Trace, and Quit, respectively. FIG. 26 illustrates a menutree structure of the Arrhythmias module 614. The menu items 2508 and2510 include a number of teaching sessions 2600 and 2602 as show in FIG.26. Selection of the Quit item 2514 directs the program 14 to exit fromthe Arrhythmias module 612.

Referring to FIG. 6 and FIGS. 27-28, selection of the Drugs module 616directs execution of the program 14 to provide information regardingdrugs. FIG. 27 illustrates a menu tree structure of the Drugs module616. The Drug module describes under the menu items 2700, 2702, and2704, the dosage, indications, uses, actions, side effects, andprecautions of a number of drugs 2708, 2710, 2712, respectively,categorized alphabetically as shown in FIG. 27. A typical screen display2800 and text box 2802 for a selected drug is shown in FIG. 28.Selection of the Quit item 2706 directs the program 14 to exit from theDrugs module 616.

Referring to FIG. 6 and FIGS. 29-30, selection of the Treatments module618 directs execution of the program 14 to provide information regardingtreatment action sequences. FIG. 29 illustrates a display screen 2900with a text box 2902 having information pertaining to the selection ofmenu items available with the Treatments module 618. The screen 2900further includes virtual instrument boxes 2004 and 2006 pertaining tovirtual instruments that include the EKG monitor 18 c and a vitalsmonitor, respectively. It is understood that these virtual instrumentsmay be controlled/operated by the mouse 12 b for simulating patient careactivity in connection with the module 618.

A menu bar 2908 includes menu items 2910-2916 directed to Treatment,Action Sequence, Trace Control, and Quit, respectively. FIG. 30illustrates a menu tree structure of the Treatments module 618.Selection of the menu item 2910 enables the user to select items 2918 or2920 for directing the program 14 to simulate a victim that is eitherresponsive or not responsive, respectively. Selection of the menu item2912 enables the user to select any of a number of treatments 2922 asshown in FIG. 30. Selection of the Trace item 2914 enables a user tospecify the speed of a simulated EKG monitor. Selection of the Quit item2916 directs the program 14 to exit from the Treatments module 618.

Referring to FIG. 6 and FIGS. 31-32, selection of the BLS Test module618 directs execution of the program 14 to test the user on CPRtechniques. Upon selection of the BLS Test item 620, the user may selectamong a plurality of action sequences 3108 to be tested in CPR with onerescuer, CPR with two rescuers, or CPR ventilation/compressiontechniques with one rescuer, or with two rescuers. The Setup menu item3102 includes selectable items 3110 for enabling the user to specifythat the action sequences 3108 comprise 2, 4, 6, or 8compression/ventilation cycles, respectively.

The Print test Results menu item 3104 directs the program 14 to recordthe time and magnitude of the compression and ventilation activityexecuted by the user on the manikin 28. It can be appreciated thatcompression and ventilation data is acquired from pressure waves sensedby the CIM 16 through the tubes 62 and 66 when the chest of the manikin28 is compressed and when air is ventilated in the trachea of themanikin. The recorded results may be displayed, similarly as shown bythe display screen 1200 (FIG. 12), on the display 12 c or the displayscreen 22 or, alternatively, may be printed on the printer 24 to therebyprovide a hard copy of the results. As shown in FIG. 12, the results maybe readily evaluated to determine whether the compression and/orventilation actions are high, or low, or are OK.

FIG. 32 shows a representative display screen 3200 that is generated bythe program 14 when one of the menu items 3108 are selected. The screen3200 includes a text box 3202 which displays information indicating whataction would be executed in a sequence of actions. A virtual instrumentgraphics box 3204 includes a compression monitor 3206 (not activated inFIG. 32) for displaying, in a comparative bar chart manner, a prescribedCPR chest compression, and an actual compression which is sensed by theCIM 16 from a pressure reading derived from the bladder 64 via thepressure line 66. The graphics box 3204 also includes a ventilationmonitor 3208 for displaying, in a comparative bar chart manner, aprescribed CPR tracheal ventilation, and an actual ventilation which issensed by the CIM 16 from a pressure reading derived from the pressureline 62. A “coach” command box 3210 is used to sequence the userbackward or forward the steps of the scenario for repeating orperforming the patient care activities at the user's own pace.Otherwise, it is understood that the scenario, once started, pacesthrough the steps of the scenario by displaying the action sequenceinstructions in the box 3202 and giving the user a predetermined time(with audio as well as visual prompts) to complete the task required,whereupon the next step in the sequence is then presented to beperformed. Thus the user is able to experience the time pressure of anactual “Code” situation according to the scenario by performing theactivities on the manikin 28 such that the system 10 senses when theactivities are being performed correctly and the user is promptedaccordingly. Selection of the end item in the box 3210 ends the sessionor possibly is programmed to end just the coaching session wherebyexecution then proceeds to the timed scenario. The Quit item 3106directs the program 14 to exit from the BLS Test module 620.

Referring to FIG. 6 and FIGS. 33-35, selection of the ACLS module 622directs execution of the program 14 to test the user on ACLS techniques.FIG. 33 illustrates a display screen 3300 with a text box 3302 havinginformation pertaining to the selection of menu items available with theACLS module 622. The screen 3300 further includes virtual instrumentboxes 3304, 3306, 3308, 3310 pertaining to virtual instruments thatinclude computer generated representations of the EKG monitor 18 c, themanual defibrillators 18 h, 18 i, a vitals monitor, and a pacer 18 f,respectively. It is understood that these virtual instruments may becontrolled/operated by the mouse 12 b for simulating patient careactivity in connection with the module 622. A menu bar 3312 includesmenu items 3314-3322 directed to Scenarios (shown selected),Instrumentation, Logging, Trace, and Quit, respectively.

FIG. 34 illustrates a menu tree structure of the ACLS module 622.Selection of the Scenarios item 3314 enables the user to select any oneof a number of different victim scenarios 3400. The Instrumentation item3316 enables the user, by further selecting items 3402 or 3404, toenable or disable the virtual instruments 18 and sensors 20 that supplyinput from the manikin 28 to the CIM 16.

Selection of the Logging item 3318 and the Enable item 3406 directs theprogram 14 to record the time and magnitude of the compression andventilation activity executed by the user on the manikin 28. Logging maybe disabled by selecting the item 3408. It can be appreciated thatcompression and ventilation data is acquired from pressure waves sensedby the CIM 16 through the tubes 62 and 66 when the chest of the manikin28 is compressed and when air is ventilated in the trachea of themanikin. The recorded results may be viewed, by selecting the View item3410, similarly as shown by the display screen 1200 (FIG. 12), on thedisplay 12 c or the display screen 22 or, alternatively, may be printed,by selecting the print item 3412, on the printer 24 to thereby provide ahard copy of the results. As shown in FIG. 12, the results may bereadily evaluated to determine whether the compression and/orventilation actions are high, or low, or are OK.

Selection of the Trace item 3320 enables the user to select an item 3414for controlling the speed of an EKG trace generated and displayed on theEKG virtual instrument screen 3304, and to select an item 3416 foradjusting the length of time that a screen appears in the scenarios.Selection of the Quit item 3322 directs the program 14 to exit from theACLS module 622.

In FIG. 35, with reference to a display screen 3500 of the ACLS module622, there is shown an example of the operation of the program 14. Thedisplay screen 3500 shows the first screen that is displayed uponselection from the screen 3300 of the menu item 3322 (FIG. 34) testscenario involving a 77 year old pulseless female victim scenario. Thetext box 3500 describes details of the selected scenario and the EKGmonitor 3304 and vital signs monitor 3308 supplement the text box withthe victim's EKG trace and vital signs. The text box 3500 also offerstest questions in the form of four possible choices from which the usermay choose to treat the victim. Four keys 3502, numbered 1-4, areprovided for the user to enter one or more of the four offered choicesof an action to follow in treating the victim. Action may also beimplemented on the manikin 28, particularly when the instrumentation3316 is enabled (item 3324). In a test situation where the user desiresto perform the patient activity without using the virtual instruments 18on the manikin 28 but instead wants to use computer-generated virtualinstruments, the defibrillator 3306 and pacer controls 3310 may beutilized if necessary to further supplement the action taken by theuser. The result of any action is reflected in the EKG monitor 3304 andin the vital signs monitor 3308, as well as in the text box 3302.Following an incorrect choice or action, an explanation is provided inthe text box 3302 of why such choice or action was incorrect. Followingeach correct choice and action, the program 14 advances the selectedscenario, e.g., until the victim recovers. The user must complete thecorrect choice, and in some instances properly perform the necessaryactivity, before the scenario proceeds to the next event. As with theBLS test module 620, the testing session allows for timed scenarioswhere the user must perform the activities correctly on the manikin 28,as confirmed by the program 14 through the CIM 16, in accordance withaccepted protocols.

It is understood that several variations may be made in the foregoingwithout departing from the scope of the invention. For example, thesystem 10 may be modified and adapted for training in pediatric advancedlife support (PALS), gynecological treatment, spinal treatment,catheterization, head trauma, burn emergencies, and the like. Suchmodification may be implemented by simply modifying the program 14and/or the virtual instruments 18 and sensors 20. A simulator maycomprise but a portion of the foregoing manikin 28, for example, thearm, head, or pelvic region. The adult-sized manikin 28 may be replacedby a manikin that simulates, for example, a newborn baby, a one-year oldchild, or a five-year old child. In further variations, additionalpatient scenarios may be modeled, and any instruments required to treatthe patient may be simulated, via the program 14 and the CIM 26, asadditional virtual instruments 18 using the techniques described above.The connection between the sensors 20, the CIM 22, and the computer 12may be effected optically (e.g., via infrared). Other medical andnon-medical simulator device training sessions are contemplated.Variations in the software GUI may also be contemplated.

Although illustrative embodiments of the invention have been shown anddescribed, a wide range of modification, change, and substitution iscontemplated in the foregoing disclosure and in some instances, somefeatures of the present invention may be employed without acorresponding use of the other features. Accordingly, it is appropriatethat the appended claims be construed broadly and in a manner consistentwith the scope of the invention.

What is claimed is:
 1. A computerized education system for interactivelyteaching patient care protocols to a user, the system comprising: acomputer program having selectable modules representing the protocols; aphysiological simulator for receiving simulated patient care activity bythe user in response to a selected module, the simulator having at leastone sensor; a virtual instrument for use with the simulator, having atleast one sensor for cooperating with the sensor of the simulator; andan interface module for interfacing the sensors with the computerprogram, the module comprising: (i) a processor for receiving signalsfrom the sensors and converting the signals to inputs for the computerprogram; and (ii) an audio chip coupled to the processor and having anassociated speaker for producing body sounds when the virtual instrumentsensor cooperates with the simulator sensor, thereby providing feedbackto the user that confirms proper use of the virtual instruments on thesimulator.
 2. The system of claim 1 wherein the interface module furthercomprises a rheostat control for adjusting the speaker volume.
 3. Thesystem of claim 1 wherein the body sounds are heart sounds.
 4. Thesystem of claim 1 wherein the body sounds are lung sounds.
 5. The systemof claim 1 wherein the body sounds are abdominal sounds.
 6. The systemof claim 1 wherein the physiological simulator is a gynecological devicehaving an associated neonatal manikin.